Spine Deformity




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Establishing consensus: determinants of high-risk and preventative strategies for neurological events in complex spinal deformity surgery

Rajiv R. Iyer, Michael G. Vitale, Adam N. Fano, Hiroko Matsumoto, Daniel J. Sucato, Amer F. Samdani, Justin S. Smith, Munish C. Gupta, Michael P. Kelly, Han Jo Kim, Daniel M. Sciubba, Samuel K. Cho, David W. Polly, Oheneba Boachie-Adjei, Peter D. Angevine, Stephen J. Lewis & Lawrence G. Lenke

doi : 10.1007/s43390-022-00482-z

Volume 10, issue 4, July 2022

To establish expert consensus on various parameters that constitute elevated risk during spinal deformity surgery and potential preventative strategies that may minimize the risk of intraoperative neuromonitoring (IONM) events and postoperative neurological deficits.

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Development of consensus-based best practice guidelines for response to intraoperative neuromonitoring events in high-risk spinal deformity surgery

Lawrence G. Lenke, Adam N. Fano, Rajiv R. Iyer, Hiroko Matsumoto, Daniel J. Sucato, Amer F. Samdani, Justin S. Smith, Munish C. Gupta, Michael P. Kelly, Han Jo Kim, Daniel M. Sciubba, Samuel K. Cho, David W. Polly, Oheneba Boachie-Adjei, Stephen J. Lewis, Peter D. Angevine & Michael G. Vitale

doi : 10.1007/s43390-022-00485-w

To expand on previously described intraoperative aids by developing consensus-based best practice guidelines to optimize the approach to intraoperative neuromonitoring (IONM) events associated with “high-risk� spinal deformity surgery.

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To tether or fuse? Significant equipoise remains in treatment recommendations for idiopathic scoliosis

K. Aaron Shaw, Michelle C. Welborn, Hiroko Matsumoto, Stefan Parent, Numera Sachwani, Ron El-Hawary, David Skaggs, Peter O. Newton, Laurel Blakemore, Michael Vitale, Amer Samdani, Joshua S. Murphy & Pediatric Spine Study Group

doi : 10.1007/s43390-022-00497-6

Vertebral body tethering (VBT) continues to grow in interest from both a patient and surgeon perspective for the treatment of scoliosis. However, the data are limited when it comes to surgeon selection of both procedure type and instrumented levels. This study sought to assess surgeon variability in treatment recommendation and level selection for VBT versus posterior spinal fusion (PSF) for the management of scoliosis.

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The Italian Spine Youth Quality of Life questionnaire: reliability and validity of the Persian version in adolescents with spinal deformities

Taher Babaee, Elham Esfandiari, Naeimeh Rouhani, Masoomeh Nakhaee, Marjan Saeedi, Zahra Hedayati, Maryam Jalali & Vahideh Moradi

doi : 10.1007/s43390-022-00475-y

To assess the reliability and validity of the Persian version of the Italian Spine Youth Quality of Life (P-ISYQOL) questionnaire.

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Asymmetrical thoracic-lumbar coordination during trunk rotation between adolescents with and without thoracic idiopathic scoliosis

Paul S. Sung & Moon Soo Park

doi : 10.1007/s43390-022-00483-y

To compare thoracic-lumbar kinematic changes and coordination based on coupling angles (CAs) in two different directions of trunk rotation between adolescents with idiopathic scoliosis (AIS) and control subjects.

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When successful, anterior vertebral body tethering (VBT) induces differential segmental growth of vertebrae: an in vivo study of 51 patients and 764 vertebrae

Tyler C. McDonald1 · Suken A. Shah1 · John B. Hargiss2 · Jeffrey Varghese1 · Melanie E. Boeyer3 · Michael Pompliano1 · Kevin Neal4 · Baron S. Lonner5 · A. Noelle Larson2 · Burt Yaszay6 · Peter O. Newton6 · Daniel G. Hoernschemeyer3 · Harms Nonfusion Study Group

doi : 10.1007/s43390-022-00471-2

This study aimed to determine (1) does vertebral body tethering (VBT) produce differential growth modulation in individual vertebrae in patients with idiopathic scoliosis, (2) does VBT change disc shape, and (3) does VBT affect total spine length?

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Anterior vertebral body tethering for idiopathic scoliosis: how well does the tether hold up?

Dhruv Shankar, Lily Eaker, Theodor Di Pauli von Treuheim, Jared Tishelman, Zacharia Silk & Baron S. Lonner

doi : 10.1007/s43390-022-00490-z

Durability of outcomes following vertebral body tethering (VBT) is a concern and may be impacted by tether breakage (TB), which has been unstudied in a large cohort. We characterized TB rates and their impact on clinical outcomes in the largest single-surgeon series to date.

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Post-operative tranexamic acid decreases chest tube drainage following vertebral body tethering surgery for scoliosis correction

Lily Eaker1 · Stephen R. Selverian1 · Laura N. Hodo2 · Jonathan Gal3 · Sandeep Gangadharan 2 · James Meyers1 · Sergei Dolgopolov4 · Baron Lonner

doi : 10.1007/s43390-022-00492-x

Anterior vertebral body tethering (VBT) is a non-fusion surgical treatment for Adolescent Idiopathic Scoliosis requiring chest tube(s) (CT). We sought to assess the efficacy of post-op intravenous tranexamic acid (IV TXA) in reducing CT drainage and retention.

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Late spinal infections are more common after pediatric than after adult spinal deformity surgery

Ijezie Ikwuezunma, Graham J. Beutler, Adam Margalit, Amit Jain, Khaled M. Kebaish & Paul D. Sponseller

doi : 10.1007/s43390-022-00494-9

To compare the incidence, timing, and microbiologic factors associated with late spinal infection (onset ≥ 6 months after index operation) in pediatric versus adult spinal deformity patients who underwent instrumented posterior spinal fusion (PSF).

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Posterior scoliosis correction with thoracoplasty: effect on pulmonary function with a mean follow-up of 4.8 years

Farhaan Altaf, Jarryd Drinkwater, Sean Mungovan, Eugene Wong, Kuk-ki Joseph Cho, Amer Sebaaly & Andrew K. Cree

doi : 10.1007/s43390-022-00486-9

To perform a study to investigate the influence of posterior scoliosis surgery and thoracoplasty on pulmonary function.

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Benchmarking surgical indications for adolescent idiopathic scoliosis across time, region, and patient population: a study of 4229 cases

Jessica H. Heyer, Keith D. Baldwin, Apurva S. Shah, John M. Flynn & the Harms Study Group

doi : 10.1007/s43390-022-00480-1

There is no identified consensus for the curve magnitude at which an adolescent idiopathic scoliosis (AIS) patient is indicated for posterior spinal fusion (PSF). We aimed to identify a benchmark for curve magnitude at which fusion is indicated; we also aimed to evaluate which patients were being fused under 50°.

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Variable Response to Antifibrinolytics Correlates with Blood-loss and Transfusion in Posterior Spinal Fusion

Breanne H. Y. Gibson, Matthew T. Duvernay, Lydia J. McKeithan, Teresa A. Benvenuti, Tracy A. Warhoover, Jeffrey E. Martus, Gregory A. Mencio, Brian R. Emerson, Stephanie N. Moore-Lotridge, Alexandra J. Borst & Jonathan G. Schoenecker

doi : 10.1007/s43390-022-00489-6

Posterior spinal fusion (PSF) activates the fibrinolytic protease plasmin, which is implicated in blood loss and transfusion. While antifibrinolytic drugs have improved blood loss and reduced transfusion, variable blood loss has been observed in similar PSF procedures treated with the same dose of antifibrinolytics.

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Correction to: Variable Response to Antifibrinolytics Correlates with Blood-loss and Transfusion in Posterior Spinal Fusion

Breanne H. Y. Gibson, Matthew T. Duvernay, Lydia J. McKeithan, Teresa A. Benvenuti, Tracy A. Warhoover, Jeffrey E. Martus, Gregory A. Mencio, Brian R. Emerson, Stephanie N. Moore-Lotridge, Alexandra J. Borst & Jonathan G. Schoenecker

doi : 10.1007/s43390-022-00507-7

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Subjective perception of spinal deformity after selective versus non-selective fusion of Lenke 1C curves

Davide Bizzoca, Andrea Piazzolla, Giuseppe Solarino, Lorenzo Moretti & Biagio Moretti

doi : 10.1007/s43390-022-00479-8

To assess the self-image perception and the Quality-of-Life (QoL) in female adolescents, with Lenke 1C scoliosis curves, treated with selective versus non-selective posterior spinal instrumentation and fusion (PSF).

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Do the benefits of hook-hybrid construct justify their use over all-pedicle screws constructs in maintaining postoperative curve correction for adolescent idiopathic scoliosis patients from an Asian population?

Samuel Wei Han Tan, Graham S. Goh, Lei Jiang & Reuben Chee Cheong Soh

doi : 10.1007/s43390-022-00493-w

(1) Compare outcomes of all-pedicle screws (PS) and hook-hybrid (H) constructs in adolescent idiopathic scoliosis (AIS) patients; and (2) investigate whether BMI, height or pedicle size may modify the effect of the type of surgical construct on the extent of curve decompensation.

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Evaluating the sagittal spinal and pelvic parameters in Marfan syndrome patients affected by scoliosis

Sukrit Jushay Suresh, Adam Margalit & Paul D. Sponseller

doi : 10.1007/s43390-022-00484-x

Spinal deformities present a common finding in patients affected with Marfan syndrome (MFS). More specifically, sagittal spine imbalances reflect the typical finding of such deformities.

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Three-column osteotomy by single-stage posterior approach in congenital and post-tubercular kyphosis: a comparison of outcomes

Bhavuk Garg, Tungish Bansal & Nishank Mehta

doi : 10.1007/s43390-022-00491-y

To compare the clinical, radiological and functional outcomes of three-column osteotomy (3CO) by a single-stage posterior approach in patients with isolated congenital angular kyphosis (CK) and healed post-tubercular kyphosis (PTK).

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Is preoperative S-albumin associated to postoperative complications and readmission in patients with adult spinal deformity: a prospective analysis of 128 patients using the Spine AdVerse Event Severity (SAVES) system

Mathilde Louise Gehrchen, Tanvir Johanning Bari, Benny Dahl, Thomas Borbjerg Andersen & Martin Gehrchen

doi : 10.1007/s43390-021-00467-4

To assess the association between preoperative S-albumin and postoperative outcome following adult spinal deformity (ASD) surgery.

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Is frailty responsive to surgical correction of adult spinal deformity? An investigation of sagittal re-alignment and frailty component drivers of postoperative frailty status

Peter G. Passias, Frank A. Segreto, Kevin A. Moattari, Renaud Lafage, Justin S. Smith, Breton G. Line, Robert K. Eastlack, Douglas C. Burton, Robert A. Hart, Shay Bess, Christopher I. Shaffrey, Christopher P. Ames, Virginie Lafage on behalf of the International Spine Study Group

doi : 10.1007/s43390-022-00476-x

Frailty has been associated with adverse postoperative outcomes. Recently, a novel frailty index for preoperative risk stratification in patients with adult spinal deformity was developed. Components of the ASD-FI utilize patient comorbidity, clinical symptoms, and patient-reported-outcome-measures (PROMS). Our purpose was to investigate components of the Adult Spinal Deformity Frailty Index (ASD-FI) responsive to surgery and drivers of overall frailty.

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SRS-22r question 11 is a valid opioid screen and stratifies opioid consumption

Paul Inclan, Travis S. CreveCoeur, Shay Bess, Jeffrey L. Gum, Breton G. Line, Lawrence G. Lenke & Michael P. Kelly

doi : 10.1007/s43390-022-00473-0

To validate the Scoliosis Research Society-22r (SRS-22r) question 11 (Q11) response as a measure to assess and quantify opioid consumption.

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Can magnetically controlled growing rods be successfully salvaged after deep surgical site infection?

Krishna V. Suresh, Majd Marrache, Jaime Gomez, Ying Li, Paul D. Sponseller & Pediatric Spine Study Group

doi : 10.1007/s43390-022-00472-1

The purpose is to compare the rate of recurrent deep wound infection in patients who retained MCGRs versus those who underwent implant removal and exchange following index deep wound infection.

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Pelvic fixation is not always necessary in children with cerebral palsy scoliosis treated with growth-friendly instrumentation

Ying Li, Jennylee Swallow, Joel Gagnier, John T. Smith, Robert F. Murphy, Paul D. Sponseller, Patrick J. Cahill & Pediatric Spine Study Group

doi : 10.1007/s43390-022-00474-z

A previous study showed that patients with neuromuscular scoliosis who underwent fusion to L5 had excellent coronal curve correction and improvement in pelvic obliquity (PO) when preoperative L5 tilt was < 15°. Our purpose was to identify indications to exclude the pelvis in children with cerebral palsy (CP) scoliosis treated with growing-friendly instrumentation.

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Scoliosis flexibility correlates with post-operative outcomes following growth friendly surgery

Riley Bowker, Kevin Morash, Amir Mishreky, Burt Yaszay, Lindsay Andras, Peter Sturm, Paul D. Sponseller, George H. Thompson, Pediatric Spine Study Group & Ron El-Hawary

doi : 10.1007/s43390-022-00481-0

The purpose of this study was to determine the relationship between pre-operative scoliosis flexibility and post-operative outcomes, including curve correction and complications, for patients who have been treated with growth friendly surgery (GFS) for early onset scoliosis (EOS).

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Does ventilator use status correlate with quality of life in patients with early-onset scoliosis treated with rib-based growing system implantation?

Sarah Beth Nossov, Alejandro Quinonez, Justin SanJuan, John P. Gaughan, Josh Pahys, Amer Samdani, Jack Flynn, Oscar H. Mayer, Sumeet Garg, Michael Glotzbecker, John Smith & Patrick J. Cahill

doi : 10.1007/s43390-021-00470-9

Pulmonary function and quality of life (QOL) are important outcome measures for patients with early-onset scoliosis (EOS) undergoing rib-based growing system (RBGS) implantation. The Assisted Ventilation Rating (AVR) measures ventilator requirements in this population.

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Does the presence of programmable implanted devices in patients with early onset scoliosis alter typical operative and postoperative practices? A survey of spine surgeons

Ryan McMahon, Sara J. Morgan, Jaysson T. Brooks, Patrick Cahill, Ryan Fitzgerald, Ying Li, Pediatric Spine Study Group & Walter H. Truong

doi : 10.1007/s43390-022-00477-w

Operative and postoperative management of early onset scoliosis (EOS) patients with programmable implanted devices has not been well characterized in the literature. The aim of this study was to describe current practices for pediatric spine surgeons who operate on patients with these devices.

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The atonic stomach: a dangerous condition prior to scoliosis surgery

P. R. van Urk, C. W. Bollen, M. H. Lequin & M. C. Kruyt

doi : 10.1007/s43390-021-00469-2

A dilated atonic stomach as part of neuromuscular or syndromic disorders can have devastating results after scoliosis surgery. Patients can be asymptomatic preoperatively and non-clinical signs can be easily overlooked. Awareness of the condition, however, can prevent severe complications such as aspiration.

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Letter to the Editor Re: “State of the art: proximal junctional kyphosis—diagnosis, management and prevention�

Pearce B. Haldeman, Ashley Robb Swan, Samuel R. Ward, Joseph Osorio & Bahar Shahidi

doi : 10.1007/s43390-021-00420-5

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Letter to the Editor for state of the art: proximal junctional kyphosis; diagnosis, management and prevention

Zeeshan M. Sardar, Yongjung Kim, Virginie Lafage, Frank Rand, Lawrence Lenke, Eric Klineberg & SRS Adult Spinal Deformity Committee

doi : 10.1007/s43390-022-00513-9

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